• Clinical and Experimental Reproductive Medicine
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• v.30 no.3
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• pp.217-222
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• 2003

Objective: To investigate the association of genetic background between MTHFR C677T genotype and infertile females with polycystic ovarian syndrome. Materials and Methods: We compared 86 infertile females with polycystic ovarian syndrome (PCOS) with 100 healthy fertile females with one or more offspring. Pyrosequencing analysis for MTHFR C677T variation was performed on polymerase chain reaction (PCR) product of study group. To validate pyrosequencing data of C677T variation for randomly selected 50 samples, we compared the pyrosequencing result with the PCR-RFLP (Restriction Fragment Length Polymorphism) result of MTHFR C677T genotype. Results: The prevalence of the C677T mutant homozygous (TT) was significantly lower (p=0.0085) in females with PCOS (8.14%) than in fertile females (21.00%). MTHFR 677 TT genotype had a decreased risk (3.7-fold) of PCOS compared with wild type (MTHFR 677 CC). Conclusion: Our data support a role for MTHFR mutant homozygous (677 TT) genotype in reducing risk in Korean infertile females with Polycystic ovarian syndrome.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.3
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• pp.146-151
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• 2017

Objective: To identify differences in the expression of the genes for peroxisome proliferator-activated receptor $(PPAR)-{\gamma}$, cyclooxygenase (COX)-2, and the proinflammatory cytokines interleukin (IL)-6 and tumor necrosis factor $(TNF)-{\alpha}$ in granulosa cells (GCs) from polycystic ovary syndrome (PCOS) patients and controls undergoing controlled ovarian stimulation. Methods: Nine patients with PCOS and six controls were enrolled in this study. On the day of oocyte retrieval, GCs were collected from pooled follicular fluid. Total mRNA was extracted from GCs. Reverse transcription was performed and gene expression levels were quantified by realtime quantitative polymerase chain reaction. Results: There were no significant differences in age, body mass index, and total gonadotropin dose, except for the ratio of luteinizing hormone to follicle-stimulating hormone between the PCOS and control groups. $PPAR-{\gamma}$ and COX-2 mRNA was significantly downregulated in the GCs of PCOS women compared with controls (p= 0.034 and p= 0.018, respectively), but the expression of IL-6 and $TNF-{\alpha}$ mRNA did not show significant differences. No significant correlation was detected between the expression of these mRNA sequences and clinical characteristics, including the number of retrieved oocytes, oocyte maturity, cleavage, or the good embryo rate. Positive correlations were found among the $PPAR-{\gamma}$, COX-2, IL-6, and $TNF-{\alpha}$ mRNA levels. Conclusion: Our data may provide novel clues regarding ovarian GC dysfunction in PCOS, and indirectly provide evidence that the effect of $PPAR-{\gamma}$ agonists in PCOS might result from alterations in the ovarian follicular environment. Further studies with a larger sample size are required to confirm these proposals.

• Clinical and Experimental Reproductive Medicine
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• v.50 no.3
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• pp.200-205
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• 2023

Objective: Polycystic ovary (PCO), a diagnostic component of polycystic ovary syndrome (PCOS), requires either an ovarian volume (OV) criterion or a follicle number per ovary (FNPO) criterion. This study investigated the association of OV and FNPO criteria with various manifestations of PCOS. Methods: This cross-sectional study was conducted at a university hospital among 100 patients newly diagnosed with PCOS (according to the revised Rotterdam criteria). Fasting blood samples were collected to measure glucose, total testosterone (TT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), lipid, insulin, and hemoglobin A1c levels. An oral glucose tolerance test was performed. Transabdominal or transvaginal ultrasound of the ovaries was done, depending on patients' marital status. All investigations were conducted in the follicular phase of the menstrual cycle. OV >10 mL and/or FNPO ≥12 indicated PCO. A homeostasis model assessment of insulin resistance (IR) value ≥2.6 indicated IR, and metabolic syndrome (MS) was defined according to the international harmonization criteria. Results: Seventy-six participants fulfilled the OV criterion, 70 fulfilled the FNPO criterion, and 89 overall had PCO. Both maximum OV and mean OV had a significant correlation with TT levels (r=0.239, p=0.017 and r=0.280, p=0.005, respectively) and the LH/FSH ratio (r=0.212, p=0.034 and r=0.200, p=0.047, respectively). Mean OV also had a significant correlation with fasting insulin levels (r=0.210, p=0.036). Multivariate binary logistic regression analysis showed that IR (odds ratio [OR], 9.429; 95% confidence interval [CI], 1.701 to 52.271; p=0.010) and MS (OR, 7.952; 95% CI, 1.821 to 34.731; p=0.006) had significant predictive associations with OV alone, even after adjustment for age and body mass index. Conclusion: OV may be more closely related to the androgenic and metabolic characteristics of PCOS than FNPO.

• Endocrinology and Metabolism
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• v.33 no.4
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• pp.447-458
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• 2018

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive-age women. Its metabolic features often overlap with those associated with metabolic syndrome (MS) and insulin resistance syndrome (IRS). The objective of this study was to determine the prevalence and predictors of MS and IRS in infertile Vietnamese women with PCOS. Methods: A cross-sectional study was conducted at a tertiary fertility centre at Hue University Hospital from June 2016 to November 2017. A total of 441 infertile women diagnosed with PCOS based on the revised 2003 Rotterdam consensus criteria were enrolled. MS and IRS were defined based on the National Heart, Lung, and Blood Institute/American Heart Association Adult Treatment Panel III 2005 and American College of Endocrinology IRS 2003 criteria, respectively. Complete clinical and biochemical measurements of 318 women were available for analysis. Independent predictors of MS and IRS were identified using multivariate logistic regression. Results: The overall prevalence of MS and IRS in women with PCOS was 10.4% and 27.0%, respectively. We identified older age (>30 years) and obesity as independent predictors of MS and IRS. Elevated anti-$M{\ddot{u}}llerian$ hormone levels increased the risk of IRS, but not that of MS. Conclusion: MS and IRS are prevalent disorders among infertile Vietnamese women with PCOS. PCOS is not solely a reproductive problem. Screening and early intervention for MS and/or IRS based on anthropometric, metabolic, and reproductive hormone risk factors should be an integral part of fertility care.

• Journal of Ginseng Research
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• v.35 no.2
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• pp.250-255
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• 2011

Polycystic ovarian syndrome (PCOS) is a very common endocrine disorder in women of reproductive age. Nerve growth factor (NGF) may be involved in the pathogenesis of PCOS. In this study, we investigated the effect of Korean red ginseng extract (KRGE) on the ovarian morphology and NGF expression in an estradiol valerate (EV)-induced rat model. Polycystic ovaries were induced by a single intramuscular injection of estadiol valerate (4 mg, dissolved in sesame oil) in adult cycling rats. KRGE was administered orally (200 mg/kg body weight/day) for 60 consecutive days, beginning 60 days after the induction. Ovarian morphology was almost normalized and NGF was normalized in the EV+KRGE group. KRGE lowered the high numbers of antral follicles and increased the number of corpora lutea in the polycystic ovaries. The results are consistent with a beneficial effect of KRGE in the treatment of PCOS.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.4
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• pp.368-373
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• 2021

Objective: In this study we aimed to assess anorexigenic peptide levels in patients with or without polycystic ovary syndrome (PCOS) and their effects on assisted reproductive treatment (ART) outcomes. Methods: A prospective case-control study was conducted in a tertiary care university-based ART clinic. Eighty-three patients were included in the study. The PCOS group included 41 patients, and the non-PCOS group included 42 controls. The 2003 Rotterdam criteria were used for PCOS patient selection. The ART indications in the non-PCOS group were tubal factor or unexplained infertility. Venous blood samples were taken on the third day of the menstrual cycle to determine the serum anorexigenic peptide levels. The enzyme-linked immunosorbent assay method was used for laboratory analyses. Results: In the PCOS group, serum obestatin levels were significantly lower than in the control group, but serum anorexigenic peptide levels were similar in PCOS patients with or without clinical pregnancy. Ovarian hyperstimulation syndrome (OHSS) was diagnosed only in PCOS patients, and the obestatin levels of OHSS patients were significantly lower than those of other PCOS patients. Conclusion: Baseline anorexigenic peptide levels did not affect the clinical pregnancy rate in ART cycles. Obestatin may play a role in the pathophysiology of OHSS. This possibility should be confirmed in further research.

• Women's Health Nursing
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• v.21 no.3
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• pp.161-170
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• 2015

Purpose: This study aimed to evaluate the impact of a lifestyle modification program on menstrual irregularity among overweight and obese women with polycystic ovarian syndrome. Methods: A quasi experimental research design was used to conduct this study on 82 women with polycystic ovarian syndrome at the Gynecology and Obesity clinics of Mansoura University Hospital, Egypt. Two groups were included; the study group received a lifestyle modification program for 48 weeks, while the control group was not subjected to this program. Data collection was done for the following variables, a structured interview questionnaire was used to assess the women's general characteristics, menstrual patterns, and 24-hour dietary recall and the researcher took anthropometric measurements and assessed hirsutism by the Ferriman-Gallwey scale. Results: After one year of lifestyle modification, the number of menstrual cycles significantly increased from $2.7{\pm}1.6$ to $6.9{\pm}1.5$ (t=12.26, p<.001) in the study group compared to insignificant minor changes among the control group (t=0.69, p=.488). Additionally, 58.5% were menstruating regularly compared to none in the control group (${\chi}^2=33.93$, p<.001). Conclusion: Participating in a lifestyle modification program was effective in reducing menstrual cycle's irregularity among overweight and obese women with PCOS. Thus, it is recommended to motivate the nurses in counseling the PCOS women on lifestyle modifications.

• Clinical and Experimental Reproductive Medicine
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• v.38 no.2
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• pp.98-102
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• 2011

Objective: To investigate the effects of pioglitazone on controlled ovarian stimulation (COS), IVF outcomes, and follicular fluid (FF) cytokine concentrations in patients with polycystic ovary syndrome (PCOS). Methods: Eighty-six infertile patients with PCOS resistant to clomiphene citrate were randomized to receive pioglitazone (30 mg/day) or placebo on the starting day of oral contraceptive (OC) pretreatment, followed by an IVF protocol using a GnRH antagonist. Pioglitazone or placebo was administered once daily from the starting day of OC to the day of hCG injection. Results: Total dose and days of recombinant follicle-stimulating hormone administered, and the numbers of retrieved and mature oocytes, were significantly lower in the pioglitazone group than in the control group. FF tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and interleukin-6 (IL-6) concentrations at oocyte retrieval were also significantly lower in the pioglitazone group. The clinical pregnancy rate was higher and the incidence of severe ovarian hyperstimulation syndrome was lower in the pioglitazone group, but the differences were not statistically significant. Conclusion: Pioglitazone reduces FF TNF-${\alpha}$ and IL-6 levels, and may improve ovarian response to COS in patients with PCOS.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.4
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• pp.255-263
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• 2009

Objective: The objective of the study was to determine the diagnostic performance of transabdominal ultrasound by receiver operating characteristic (ROC) curve analysis, in order to evaluate the usefulness in establishing the diagnosis of polycystic ovary syndrome (PCOS). Methods: Questionnaires were given to 8,793 reproductive women reviewed at Ewha Womans University Mokdong hospital. Ultrasound examinations were performed in 701 women with a transabdominal transducer. Transabdominal ultrasounds were performed in 185 normal control women (normal menstruation without hyperandrogenism or PCO morphology) and 248 PCOS patients according to National Institutes of Health (NIH) PCOS diagnosis criteria. ROC curves were calculated for ovarian volume and follicle number. Results: In normal control group, the mean age were $23.64{\pm}4.26$ years old and the mean ovarian volume and follicle number were $6.03{\pm}1.89\;cm^3$ and $6.49{\pm}1.93$, respectively. The ovarian volume showed an area under the ROC curve (AURC) of 0.761. A ovarian volume decision threshold >$9\;cm^3$ had a sensitivity of 51.0% and a specificity of 91.4% for the diagnosis of PCOS. The follicle number showed an AURC of 0.733. A follicle number decision threshold ${\geq}9$ had a sensitivity of 54.9% and a specificity of 87.0% for the diagnosis of PCOS. A follicle number decision threshold ${\geq}10$ had a sensitivity of 53.2% and a specificity of 90.4%. A follicle number and a ovarian volume did not have a high diagnostic power for screening for PCOS. Conclusion: Our results suggest that transabdominal ultrasound assessment is not effective for the detection of PCOS in young women of reproductive age.

• The Journal of Korean Obstetrics and Gynecology
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• v.27 no.4
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• pp.25-42
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• 2014

Objectives: To observe the effects of Herb medication on Polycystic Ovary (PCO) in rats. Methods: Riss (Research Information Sharing Service) was searched for Oriental medicine about PCO on 2000~2014. So, Experimental studies using PCO model induced by Estradiol Valerate (EV) was selected to analyze how effects they were. Consequently, 10 studies published on 2000~2014 were selected to analyze about weight of model and both ovaries, the number aries, the number of follicle and corpus of follicle and corpus luteum, the level of serum Androstenedione (ADD) and total estrogen, the level of Nerve Growth Factor (NGF) and Corticotropin Releasing Factor (CRF), the crossover rate and the number of implantation. Results: Among them, there was significantly difference between treatment group and control group in weight of both ovaries, the number of follicle and corpora lutea, the crossover rate and the number of implantation. Conclusions: The effects of Herb medication was observed on making weight of ovaries with PCO to promote. The study about effect of Herb medication on NGF and CRF with PCOS had to be conducted. The further research have to focus on treatment of subfertility and infertility, that is field showing the advantage of Oriental medicine.